1. Short title
This Act may be cited as the “End Neglected Tropical Diseases Act”.
End Neglected Tropical Diseases Act
A BILL
To facilitate effective research on and treatment of neglected tropical diseases through coordinated domestic and international efforts.
2. Table of contents
The table of contents for this Act is as follows:
3. Statement of policy
It is the policy of the United States to support a broad range of implementation and research and development activities that work toward the achievement of cost-effective and sustainable treatment, control and, where possible, elimination of neglected tropical diseases for the economic and social well-being of all people.
4. Findings
Congress finds the following:
The Centers for Disease Control and Prevention have identified 17 neglected tropical diseases (referred to in this section as “NTDs”). Approximately 2,000,000,000 people are at risk of contracting an NTD, and more than 1,040,000,000 people are currently afflicted with 1 or more NTDs.
In 2012, the London Declaration on Neglected Tropical Diseases identified 10 NTDs with the potential to be controlled, eliminated, or eradicated by 2020.
In 2013, the World Health Organization (referred to in this section as “WHO”) adopted a comprehensive resolution on NTDs, recognizing that increased national and international investments in prevention and control of these diseases have succeeded in improving health and social well-being in many countries. WHO’s World Health Assembly maintains and updates a list of the diverse NTDs across the world.
In its fourth Update Report, published in 2017, WHO reported significant progress in expanding NTD interventions worldwide, but challenges continue in—
developing improved evaluation and surveillance tools; and
maintaining sufficient funding to ensure that progress is sustained.
NTDs have an enormous impact in terms of disease burden and quality of life. NTDs cause the loss of up to 185,000 lives and up to 2,500,000,000 disability-adjusted life years each year. NTDs surpass both malaria and tuberculosis in causing greater loss of life-years to disability and premature death. Many NTDs cause disfigurement and disability, in addition to significant morbidity and mortality, leading to stigma, social discrimination, and societal marginalization.
NTDs create an economic burden of billions of dollars through the loss of productivity and high costs of health care required for treatment. People afflicted by NTDs are less productive than their healthy counterparts. NTDs jeopardize the ability of people to attend work and school, or to produce at full capacity. For example, controlling 1 NTD (hookworm) in children can result in a 43 percent increase in future wage earnings.
The social, economic, and health burden of NTDs falls primarily on low- and middle-income countries, where access to safe water, sanitation, and health care is limited. At least 100 countries face 2 endemic NTD burdens, and 30 countries carry six or more endemic NTDs. All low-income countries are affected by at least 5 NTDs, and 149 countries and territories are affected by at least 1 NTD.
NTDs are not confined to the developing world. Several NTDs have been reported in the United States and other developed countries. In the United States, NTDs disproportionately affect communities of color and the poor, with up to 2,850,000 African Americans suffering from toxocariasis and at least 300,000 people, who are mostly Hispanic Americans, are afflicted with Chagas disease.
Many NTDs can be controlled, prevented, and even eliminated using low-cost, effective, and feasible solutions. Understanding the economic burden of NTDs on productivity and health care costs can help to assure governments and donors that the resources directed toward NTDs represent a good investment.
Research and development efforts are immediately needed for all NTDs, especially to advance next-generation treatments, interventions, and diagnostics to ensure that countries endemic for NTDs are able to implement and sustain NTD control programs.
Epidemiological data that identify at-risk populations and ensure that these populations receive consistent and sufficient doses of treatment for their diseases are critical to developing robust NTD control strategies.
The benefits of deworming are immediate. A rigorous, randomized controlled trial has shown school-based deworming treatment to reduce school absenteeism by 25 percent. School-based deworming also benefits young siblings and other children who live nearby but are too young to be treated, leading to large cognitive improvements equivalent to 1/2 of a year of schooling.
Improved access to water, sanitation, and hygiene can also reduce the transmission of NTDs, particularly NTDs caused by parasites.
5. Definitions
In this Act:
Global Fund— The term Global Fund means the public-private partnership known as the Global Fund to Fight AIDS, Tuberculosis, and Malaria established pursuant to Article 80 of the Swiss Civil Code.
Neglected tropical diseases; NTDs— The terms neglected tropical diseases and NTDs—
mean infections caused by pathogens, including viruses, bacteria, protozoa, and helminths, that disproportionately impact individuals living in extreme poverty, especially in developing countries; and
include—
Buruli ulcer;
Chagas disease;
Cysticercosis;
Dengue fever;
Dracunculiasis (Guinea worm disease);
Echinococcosis;
Fascioliasis;
Human African trypanosomiasis (sleeping sickness);
Leishmaniasis;
Leprosy (Hansen’s disease);
Lymphatic filariasis (elephantiasis);
Onchocerciasis (river blindness);
Rabies;
Schistosomiasis;
Soil-transmitted Helminthiases (STH), such as round worm, whip worm, and hook worm;
Trachoma; and
Yaws.